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What is a high-risk pregnancy?

Dr. Deborah Raines, MSN
Nursing Specialist

A pregnancy is considered high risk when the life or health of the mother or fetus is threatened because of a situational circumstance, pre-gestational condition or conditions that occur because of the pregnancy. Some risk factors for a high-risk pregnancy include:

  • Age (less than 20 years or more than 35 years)
  • Lack of prenatal care
  • Low educational level/Low socio-economic status
  • Nutritional status
  • Blood type (Rh negative)
  • Parity
  • Multiple gestation pregnancy
  • Pre-existing chronic illness
  • Smoking
  • Substance abuse
  • Previous uterine surgery
  • History of miscarriages, stillbirths, or poor obstetrical outcomes.

Some pregnancies are classified as high-risk from the beginning, whereas in other pregnancies a condition develops during the gestational period that makes the pregnancy high risk.

Pregnancies with a greater chance of complications are called "high-risk." But this does not mean there will be problems. The following factors may increase the risk of problems during pregnancy:

  • Very young age or older than 35
  • Overweight or underweight
  • Problems in previous pregnancy
  • Health conditions you have before you become pregnant, such as high blood pressure, diabetes, autoimmune disorders, cancer, and HIV
  • Pregnancy with twins or other multiples
  • Health problems also may develop during a pregnancy that makes it high-risk, such as gestational diabetes or preeclampsia.

Women with high-risk pregnancies need prenatal care more often and sometimes from a specially trained doctor. A maternal-fetal medicine specialist is a medical doctor that cares for high-risk pregnancies.

If your pregnancy is considered high risk, you might worry about your unborn baby's health and have trouble enjoying your pregnancy. Share your concerns with your doctor. Your doctor can explain your risks and the chances of a real problem. Also, be sure to follow your doctor's advice. For example, if your doctor tells you to take it easy, then ask your partner, family members, and friends to help you out in the months ahead. You will feel better knowing that you are doing all you can to care for your unborn baby.

This answer is based on source information from National Women's Health Information Center.

Paula Greer
Midwifery Nursing Specialist

A high-risk pregnancy is one where there is a greater chance of complications due to mom’s previous conditions she had before the pregnancy or potentially developed during the pregnancy. It is important to know when you are a high-risk pregnancy so that you can select the appropriate level of care and the right practitioner and the right location or center to deliver.

Situations that existed prior to pregnancy that might complicate the pregnancy are previous diseases like high blood pressure, diabetes, autoimmune or heart diseases, cancer and HIV.

Situations that are a result of the pregnancy might be multiple gestations like twins and triplets, gestational diabetes, preterm labor, incompetent cervix, pregnancy induced hypertension.

Other factors that might affect your pregnancy would be age i.e. the very young or elder woman who is considered advanced maternal age for pregnancy, being severely underweight or morbidly obese.

Definitely having a history of previous pregnancy complications like fetal losses or preterm labor will put subsequent pregnancies at risk. Having a known serious birth defect of the baby or serious growth problems will also make the pregnancy high risk.

Home birth and birthing centers specialize in safe midwifery care for women who are at low risk for complications.

Hospital birth by either midwives in collaborative practice with MDs and or by OB/Gyn's may be utilized by clients with some high-risk patients but patients who are very high risk may need the care of a specialized doctor called a maternal fetal medicine specialist and the mom and or the baby may need to be delivered in a tertiary center equipped to handle the special needs of mom or her baby.

If your doctor has determined you have a "high-risk" pregnancy, it is because of medical conditions that don't usually arise during a "normal" pregnancy. It means that your pregnancy will have to be managed differently and monitored more closely.

High-risk pregnancies occur in less than 10 percent of all pregnancies in the U.S. However, the complications for mother and baby can be serious, including preeclampsia, preterm delivery, miscarriage or stillbirth. "More women are waiting until later in life to have children, and their increased age may also increase their risk for complications during pregnancy," says UCLA maternal and fetal medicine specialist Daniel Kahn, MD, PhD.

Among the most common reasons for high-risk pregnancy are older age of the mother, preexisting health problems in the mother, previous pregnancy complications, pregnancy with multiples and problems in the developing baby.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.